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DKG statement on the use of metal alloy discs for patch testing in suspected intolerance to metal implants
Author(s) -
Thomas Peter,
Geier Johannes,
Dickel Heinrich,
Diepgen Thomas,
Hillen Uwe,
Kreft Burkhard,
Schnuch Axel,
Szliska Christiane,
Mahler Vera
Publication year - 2015
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/ddg.12773
Subject(s) - patch testing , medicine , nickel allergy , allergy , contact allergy , implant , surgery , contact dermatitis , immunology
Summary Intolerance reactions to metal implants may be caused by metal allergy. However, prior to implantation, ‘prophetic’/prophylactic patch testing should not be performed. Pre‐implant patch testing should only be done to verify or exclude metal allergy in patients with a corresponding history. In case of implant‐related complications – in particular following replacement arthroplasty – such as pain, effusion, skin lesions, reduced range of motion or implant loosening, orthopedic causes should be ruled out first. Workup of suspected metal implant allergy should then be done using the DKG standard series, which includes nickel, cobalt, and chromium preparations. Various studies assessing the usefulness of metal alloy discs for patch testing have shown this particular approach to be ineffective with respect to providing reliable information on metal allergy. Any positive reaction in such tests cannot be assigned to a specific metal contained within the alloy. Furthermore, there is a risk of broad and indiscriminate use of these readily available discs. Accordingly, given the lack of additional benefit compared to patch testing with standardized metal salt preparations, we do not recommend patch testing with metal alloy discs.